Corticosteroids for JIA

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Corticosteroids are often called steroids. However, the word steroid can be confusing. Corticosteroids are very different from the steroids some athletes take to do better in their sport.

Corticosteroids are hormones produced naturally by your body. One corticosteroid in your body is called cortisone. Corticosteroids are important for your body metabolism. This means they help your body convert the food you eat into the energy you need to do things.

Corticosteroids are also very powerful medicines. They help to control or turn off inflammation quickly. They do this by acting on your immune system.

Corticosteroids work much faster than the slower acting NSAIDs. Corticosteroids can improve your symptoms in as little as 48 hours. Corticosteroids can be given in different ways:

  • Orally
  • Through an IV (systemic corticosteroids)
  • Locally (such as directly injecting into inflamed joints)
  • As eye drops for inflamed eyes due to JIA

What are the side effects of corticosteroids?

Corticosteroids may have more side effects than NSAIDs. They can affect almost every type of tissue and organ in your body. Corticosteroids are not commonly used in young people with JIA. If you need to take corticosteroids, your doctor will use the smallest dose for the shortest period of time.

Corticosteroids may be used for:

  • children and teenagers with severe JIA who need treatment while waiting for other medications to start to work
  • children and teenagers with systemic JIA
  • rarely in children and teenagers where other medications have not worked.

Types of corticosteroids

The following are corticosteroids commonly used to treat JIA. Two of these are given orally, and one is given by IV. Prednisone is the most commonly used oral corticosteroid in the treatment of JIA.

Generic nameMost common brand nameHow it is givenHow the medication comesSide effects
PrednisonePrednisoneBy mouth, 1-3 times dailyLiquid or pill

Early side effects:

  • Increased appetite
  • Stomach ache or burning, nausea
  • Trouble sleeping, mood changes

Late side effects:

  • Weight gain, puffy face, acne, increased body hair and stretch marks
  • Stomach ache or burning, nausea
  • Trouble sleeping, mood changes
  • Changes in menstrual pattern
  • May reduce the activity of the immune system and you may see more frequent infections
  • Fluid retention/swollen feet and/or ankles
  • High blood pressure
  • Cataract formation
  • High blood sugar (increased thirst frequent urination)
  • Reduced blood flow to bone causing bone softening (avascular necrosis)
  • Osteoporosis (fractures, back or rib pain)
  • Slowing of growth in height
PrednisolonePediapredBy mouth, 1-3 times dailyLiquid

Important safety points about taking corticosteroids

  • Stomach upset can frequently be avoided by taking the medication with food. If you continue to have stomach aches with this medication, your doctor may prescribe a medication to help protect your stomach. One of the rare side effects of corticosteroids is stomach ulcers. Signs of an ulcer may include vomiting blood or passing a bloody or black stool. If this occurs, you should see your doctor immediately.
  • If you have a fever, chills, or other symptoms of infection, see your doctor as soon as possible.
  • You should not take live vaccines (MMR, varicella) while taking steroids.
  • If you have not had chicken pox and are exposed to someone who has chicken pox, contact your doctor as soon as possible.
  • When you take a corticosteroid medication for a prolonged period of time (more than three months), you should wear a Medic-Alert bracelet or necklace (see If you are in an accident or need surgery, the emergency medical personnel will know that you need extra medication. Your body needs extra cortisone during these times.

It is important to speak to your doctor about the side effects of corticosteroids. You may not like taking corticosteroid medication because of its side effects. In fact, you may feel like stopping it. However, corticosteroids should never be stopped suddenly. They should be gradually reduced according to your doctor’s instructions. This allows your body to start producing its own corticosteroids again. Stopping corticosteroids too quickly can lead to serious side effects. Remember, talk to your doctor or nurse about any concerns you might have about taking corticosteroids.

Tips for managing side effects of oral corticosteroids

It is hard to take a medication that can change the way you look. The changes will depend on how much corticosteroid you need to get better. If your face gets rounder, remember that this will go away when your dose is lowered. The toughest part for most teenagers is the increased appetite. Here are a few tips for managing the side effects of corticosteroids.

  • Take your corticosteroids with food. Try taking your pills with breakfast, lunch or dinner. If you need to take your medications at school, carry a small snack with you.
  • Eating right and staying active will help to minimize side effects such as weight gain, osteoporosis, increased cholesterol, and changes in blood pressure. Your rheumatology health care team can help to review your diet. They may suggest avoiding too many salty, fatty and sugary foods. Other tips for planning your diet while on corticosteroids can be found in the article titled "Nutrition and JIA."
  • Corticosteroids can make your bones weaker. You can help reduce this by taking in enough calcium and vitamin D in your diet along with staying active. You may need to take vitamin supplements. Talk with your doctor or nurse about how much you should take.
  • To minimize acne, wash regularly with soap and water. If that does not help, speak to your doctor about other lotions that help to control acne caused by corticosteroids.
  • To help with stretch marks, try to maintain a healthy diet. Avoid excessive sun exposure to the stretch mark or use sun protection. Apply vitamin E to the stretch mark.
Last updated: January 31st 2017